Li Chao, Hou Ying, Wang Xu, Li Yue-Xuan, Li Feng, Zhang Chao, Li Wei-Guo
Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China.
Department of Brain Function Remodeling, Institute of Brain and Brain-Inspired Science Research, Shandong University, Jinan, China.
Front Neurol. 2021 Apr 6;12:653833. doi: 10.3389/fneur.2021.653833. eCollection 2021.
Non-motor symptoms in PD usually arise at very early stage and vary during the whole disease progression. Deep brain stimulation (DBS) is considered as a highly efficient treatment option for PD's motor function. However, the effect of DBS on NMS, especially hyposmia, has not been fully understood and the deep connection between different NMS such as hyposmia and constipation is still unknown. The objective of this study was to evaluate the therapeutic effect of DBS on hyposmia in PD patients with or without constipation and find potential factors which might influence the efficacy. A retrospective analysis of 65 PD patients accepted STN-DBS operation in Qilu Hospital during 2019-2020 were conducted to evaluate the exact therapeutic effect of DBS on hyposmia in PD. Sub-group analyses about the relationship between hyposmia and constipation were carried out. Analysis of flora in nasal mucosa was also conducted to evaluate the abundance and variety in different PD groups. Our study showed that DBS had clearly improved olfactory function in Parkinson patients ( = 0.012) and subgroup analysis found that PD patients with constipation have lower olfactory function scores (25.27 ± 3.44 vs. 33.90 ± 6.633, = 0.014) and worse improvement after DBS operation (ΔTDI 12.11 ± 3.2 vs. 8.78 ± 2.91, = 0.0072). Analysis of flora indicated the obvious discrepancy on olfactory function scores and degree of improvement might be related to the abundance and dysbiosis of microbiota. In summary, this article presents a study on PD with hyposmia and constipation after DBS operation, explored the relationship between different NMS and offer a potential explanation on why PD patients with constipation usually have worse olfactory function for the less abundance and variety of microbiota.
帕金森病（PD）的非运动症状通常在疾病早期出现，并在整个疾病进展过程中有所变化。深部脑刺激（DBS）被认为是治疗PD运动功能的一种高效方法。然而，DBS对非运动症状的影响，尤其是嗅觉减退，尚未完全明确，嗅觉减退和便秘等不同非运动症状之间的深层联系仍不清楚。本研究的目的是评估DBS对有或无便秘的PD患者嗅觉减退的治疗效果，并找出可能影响疗效的潜在因素。对2019年至2020年期间在齐鲁医院接受丘脑底核DBS手术的65例PD患者进行回顾性分析，以评估DBS对PD患者嗅觉减退的确切治疗效果。对嗅觉减退与便秘之间的关系进行了亚组分析。还对鼻黏膜中的菌群进行了分析，以评估不同PD组中的菌群丰度和种类。我们的研究表明，DBS明显改善了帕金森病患者的嗅觉功能（P = 0.012），亚组分析发现，便秘的PD患者嗅觉功能评分较低（25.27±3.44 vs. 33.90±6.633，P = 0.014），DBS手术后改善较差（ΔTDI 12.11±3.2 vs. 8.78±2.91，P = 0.0072）。菌群分析表明，嗅觉功能评分和改善程度的明显差异可能与微生物群的丰度和失调有关。总之，本文介绍了一项关于DBS手术后伴有嗅觉减退和便秘的PD的研究，探讨了不同非运动症状之间的关系，并对便秘的PD患者嗅觉功能通常较差的原因提供了一种潜在解释，即微生物群丰度和种类较少。
